Finding the right words in connected speech: An examination of word-finding difficulties in persons with multiple sclerosis

Self-reported word-finding difficulties are common in people with multiple sclerosis (PwMS). A lack of suitable methods for assessing these sometimes-subtle word-finding difficulties in PwMS has been highlighted. The aim of this study was to investigate how word-finding difficulties can be detected and how they manifest themselves in connected speech in PwMS compared to non-brain-damaged (NBD) controls. Twenty-seven PwMS with self-reported anomia and 23 NBD controls performed a video-retelling task which was evaluated by (i) counting the number and types of indicators of word-finding difficulties, (ii) main-concept analysis (MCA), and (iii) correct-information-unit (CIU) analysis. Additionally, correlations between word-finding ability in connected speech, picture-naming ability, verbal fluency and demographic and disease-related factors were explored. Content analysis of connected speech proved to be successful in confirming self-perceived difficulties. In line with their own perceptions, word-finding difficulties were significantly more frequent in the MS group than in the NBD group (U = 144, p < .001). The overall distribution of WFD types differed significantly between groups, χ²(13) = 76.21, p < .001. In particular, the MS group had significantly more pauses and lower speech rate (U = 89, p < .001). In the MS group, a high frequency of indicators of word-finding difficulties was related to low MCA and CIU scores and to a low score on a phonemic verbal-fluency test, but no correlations were found between word-finding difficulties on the one hand and age, years of education, or disease-related factors such as MS type, disease duration, or Expanded Disability Status Scale (EDSS) score on the other.